他汀类药物对预防胆囊结石形成及降低胆囊切除风险的系统评价

发布时间：2018-03-07 14:27

本文选题：他汀类药物　切入点：胆囊结石　出处：《重庆医科大学学报》2015年02期 　论文类型：期刊论文

【摘要】：目的:系统评价他汀类药物在预防胆囊结石形成及降低胆囊切除风险的疗效。方法:计算机检索Pub Med,EMBASE,Cochrane Central Register of Controlled Trials,中国生物医学文献数据库和维普数据库等,全面搜集并纳入他汀类药物预防胆囊结石形成及降低胆囊切除风险相关的临床研究。采用Rev Man5.0软件及Stata11.0软件对数据进行Meta分析。结果:纳入14篇文献,其中有5篇随机对照试验(randomized controlled trails,RCTs),3篇自身前后对照,共计140人;另外还有4篇病例对照研究,2篇队列研究,共观察811 393人,胆囊切除患者65 605例,745 788例健康人群。RCTs及自身前后对照研究结果示:他汀类药物组在降低胆汁胆固醇方面,差异有统计学意义(SMD=0.41,95%CI=0.08~0.73,P=0.009);他汀类药物组在降低胆固醇饱和指数方面优于对照组,差异有统计学意义(SMD=0.53,95%CI=0.22~0.84,P=0.001)。病例对照及队列研究结果示:他汀类药物暴露1~2年(OR=0.89,95%CI=0.84~0.94)、大于2年(OR=0.79,95%CI=0.67,0.94),较暴露时限小于1年(OR=1.13,95%CI=1.04,1.22)在降低胆囊切除风险方面,差异有统计学意义。结论:他汀类药物的治疗能降低患者体内胆固醇饱和指数以及胆汁内胆固醇浓度,可能对抑制胆囊结石的形成有一定的作用。他汀类药物暴露1年以上可能有降低胆囊结石患者胆囊切除的风险。
[Abstract]:Objective: to evaluate the efficacy of statins in preventing gallstone formation and reducing the risk of cholecystectomy. Methods: Pub Medmella Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database and Weip Database were searched by computer. To collect and integrate statin drugs to prevent gallstone formation and reduce the risk of cholecystectomy. The data were analyzed by Meta using Rev Man5.0 software and Stata11.0 software. Among them, 5 randomized controlled trails were randomized, 3 were self-controlled, and a total of 140 were involved. In addition, there were 4 case-control studies and 2 cohort studies, with a total of 811 393 people observed. 65,605 patients with cholecystectomy and 745788 healthy controls. The results of the study showed that statin group could reduce cholesterol in bile. The difference was statistically significant (P < 0.05). The statin group was superior to the control group in lowering the cholesterol saturation index. The results of case-control and cohort studies showed that the risk of cholecystectomy was decreased in patients with statin exposure from 1 to 2 years after exposure to OR0.89 + 95CIT 0.84U, which was larger than that of 2-year OR0.79 / 95CI0.670.94. the duration of exposure was less than one year OR1.1395CIT 1.041.22). Conclusion: statins can reduce cholesterol saturation index and cholesterol concentration in bile. Statins may reduce the risk of cholecystectomy in patients with cholecystolithiasis after being exposed to statin for more than one year.
【作者单位】：第三军医大学西南医院全军消化病研究所;
【分类号】：R575.62

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